Rationale of Longitudinal Cohort Study on Obstetrical Outcomes of Trichomonas vaginalis Infection in Kinshasa, DR Congo

Background: Trichomoniasis is the most common non-viral sexually transmitted infection (STI) in the world, and the occurrence of this infection during pregnancy is responsible for adverse obstetrical outcomes like premature labor, premature rupture of membranes (PROM) and low birth weight (birth weight < 2500 g). The association with a number of factors (maternal age, low level of education, low socio-economic status and multiple sexual partners, etc.) that can be found in our environment suggest its probably high prevalence amongst vaginal infections that are responsible for adverse obstetrical outcomes, but up-to-date estimates are lacking. Objective: To assess the obstetrical risk associated with Trichomonas vaginalis (T. vaginalis) infection in our environment. Methods: We designed a protocol for a prospective cohort study which will take place in four medical facilities in the city of Kinshasa, where all pregnant women with a pregnancy of at least 20 weeks and who will give written consent will be included. Vaginal swab specimens will be collected for T. vaginalis research by direct microscopy wet mount. Follow-up will consist of recording the process of the pregnancy and obstetrical outcomes. Conclusion: Results from this study will allow to enhance management and also bring updated estimates on T. vaginalis prevalence and its obstetrical outcomes for infected pregnant woman in our environment.

OBSERVATION OF THE EFFECT OF S－（－）USNIC ACID SODIUM ON TRICHOMONAS VAGINALIS BY TRANSMISSION ELECTRON MICROSCOPE

This paper reports the ultrastructural changes of trichomonas vaginaiis (T. vag. ) under the action of s-(-)usnic acid sodium in vitro. These changes can be shown by the following results:At first, the degranulation of the rough endoplasmic reticulum (RER) took place, the polyribosomes disaggregated. And then, the Golgi complex and the endoplasmic reticulum dilated. The cytoplasmic matrix presented and inhomogeneous apperance. Finally, the biomembrane loosed and fractured.The cell nuclei presented the karyorrhexis.

Trichomonas vaginalis and Chlamydia trachomatis Prevalence,Incidence and Associated Factors in Pregnant Adolescents from Belém City,in the Brazilian Amazon

Background: Adolescents are disproportionally affected by sexually transmitted infections (STI). Chlamydia trachomatis (CT) and Trichomonas vaginalis (TV) are the most frequent curable STI in adolescents, causing serious consequences for their reproductive health. Therefore, we aimed to determine the prevalence and incidence of CT and TV, as well as their risk factors in pregnant adolescents from Belém, northern Brazilian Amazon. Methods: This prospective study enrolled 199 adolescents up to 20 weeks of pregnancy. They were scheduled for follow-up visit between 28 and 29 weeks of pregnancy. Sociodemographic and behavioral data were obtained by interview. Cervicovaginal samples were taken to test for TV, CT, Neisseria gonorrhoeae and bacterial vaginosis. Univariate and multivariate analyses were performed to test the association of prevalent/incident CT and TV with the variables. Results: Prevalence of cervical CT infection was 33.7% (n = 67/ 199), and for trichomoniasis it was 4.0% (n = 8/199). Cervical ectopy increased the risk for prevalent CT (OR, 1.93;95% CI, 1.01 - 3.70), while having treated vaginal discharge in the past (OR, 0.51;95% CI, 0.26 - 0.98) and being married (OR, 0.10;95% CI, 0.01 - 0.83) were protective against current CT and TV, respectively. Among the 95 (47.7%) adolescents who completed follow-up, 15 cases of incident CT were identified. Incident CT was associated with having a formal or informal job (OR, 28.4;95% CI, 2.1 - 391.6) and bacterial vaginosis treatment at the baseline (OR, 0.08;95% CI, 0.01 - 0.69). Conclusion: Prevalence and incidence rates of TV and CT are high in this population devoid of STI routine screening. Treatment of bacterial vaginosis may benefit this population by reducing risk for CT acquisition.

Comparative drug susceptibility study of five clonal strains of Trichomonas vaginalis in vitro

Objective:To produce comparative data on a group of Trichomonas vaginalis clonal strains with varied drug responses using identical methods and materials.Methods:Five clonal strains of Trichomonas vaginalis were isolated from reference strain using agar plate technique.The variability of growth kinetic and susceptibility of clonal strain to metronidazole,tinidazole, satranidazole and nitazoxanide were observed in 96 well microlilre plate.Results:Among these clonal strains there was a good correlation between rates of growth with the relative susceptibility of the strains to drugs in vitro.Regarding metronidazole,tinidazole and satranidazole susceptibility,different degrees of susceptibility were determined.However,no difference in nitazoxanide susceptibility was found between the clonal strain tested and a reference strain. Conclusions:This is the first description of biological variability in clonal stock of Trichomonas vaginalis.Different degrees of drug susceptibility were determined among clonal strains tested. Further studies will be necessary to ascertain the importance of this variability in clinical infection.

<i>Toxoplasma gondii</i>But Not <i>Leishmania major</i>or <i>Trichomonas vaginalis</i>Decreases Cell Proliferation and Increases Cell Death on Fibrosarcoma Cancer Cells in Culture Medium

It has been shown that some parasites interfere with malignant tumor cells growth in vivo or in vitro. In this work anticancer activity of three live protozoan parasites;Toxoplasma gondii, Trichomonas vaginalis and Leishmania major on fibrosarcoma cells growth has been investigated in cell culture medium. In this experimental study, WEHI-164 fibrosarcoma cells treated with alive Toxoplasma gondii tachyzoite, Trichomonas vaginalis trophozoite or Leishmania major promastigote as case groups or left intact as control groups. Following 24 hours incubation the number of cells, lactate dehydrogenase (LDH) and apoptosis were determined in case and control groups. Toxoplasma gondii tachyzoite decreased cell proliferation and increased cell lyses’ but it did not induce apoptosis. Trichomonas vaginalis or Leishmania major didn’t show any effects on cell proliferation, cell lyses or apoptosis. Therefore Toxoplasma gondii may have anticancer activity and further works is recommended to understand the mechanisms of action.

Incidence of Trichomonas vaginalis among Internally Displaced Women in Ibaka, Akwa Ibom State, Nigeria

A total of 282 outpatient pregnant antenatal and non-pregnant women from internally displaced camps attending the Poly Health Clinic (PHC) and the Enwang Health Centre (EHC) were examined for Trichomonas vaginalis infection. Direct wet mount microscopy and Giemsa staining techniques were used on High Vaginal Swab (HVS) specimens collected on sterile swab sticks. A prevalence of 20 (57.1%) was recorded using both methods;12 (7.2%) in PHC and 08 (6.2%) in EHC Mbo local government area, Akwa Ibom State respectively. Differences among pregnant and non-pregnant women used were statistically significant (P < 0.05). Women in the age group 15 - 19 years had the highest prevalence of infection 03 (10.5%), closely followed by those of age group 20 - 24 years 6 (6.8%). A total number of 14 (6.7%) infections were recorded among married women followed by single women with 06 (10%). A higher prevalence rate of 01 (24%) was recorded among women who attended Quranic level of education and 04 (16.7%) with uneducated women, this may be due to small sample size within this group of women. 12 (6.5%) in women with primary school education and 03 (4.7%) in women with secondary school level of education. The need for improved personal hygiene in IDP camps and other effective intervention programmes among these vulnerable groups of women is advocated.

Trichomonas vaginalis and human papillomavirus:Association with the microbiota and burden on the cervix

Trichomoniasis and HPV infection are common non-viral and viral sexually transmitted diseases worldwide.Emerging evidence shows that the female genital tract and its microbiota are greatly affected by these pathogens.However,the relationship between Trichomonas vaginalis,the vaginal microbiome,and High-risk(HR)-HPV infection is complex and multifaceted.Studies have proven that concurrent infections of HIV and HPV increase the risk of cervical cancer.With this basis,a question arises:How does the concurrent infection of trichomonas vaginalis and HPV affect genital tract health?Does this concurrent infection enhance or inhibit the development of cervical lesions?This review aims to bring light to these questions.This review also covers the association of trichomonas vaginalis and HPV with the microbiota of the genital tract.

Ultrastructural and immunohistochemical studies on Trichomonas vagi nalis adhering to and phagocytizing genitourinary epithelial cells

Background Trichomonas vaginalis (T. vaginalis ) belongs to a common sexually transmitted disease pathogen causing genitourinary trichomoniasis in both sexes. We investigated the pathogenetic mechanism of gen itourinary trichomoniasis.Methods Cultured T. vaginalis bodies were injected into the vaginas of rats, or incubated with genitourinary epithelial cells of female subjects, male subjects, and sperm. The ultrastructural and microscopic changes were observed via transmission and scanning electron microscopy and through microscopic histochemistry.Results Groups of T.vaginalis adhered to PAS positive colum nar cells at the surface of stratified epithelium in the middle and upper portions of the vaginas. They a lso traversed under these cells. The parasites were shown to be PAS, cathepsin D, and actin positive, and they could release hydrolase into the cytoplasm of adher ed epithelial cells. In the amebiform T.vaginalis, microfilaments were arranged into reticular formation. Similar phenomena were found during the interaction of T.vaginalis with host cells, both in vitro and in vivo. Usually several protozoa adhered to a n epithelial cell and formed polymorphic pseudopodia or surface invaginations to surround and phagocytize the microvilli or other parts of the epithelial cytoplasm. Adhesion and phagocytosis of sperm by the protozoa occurred at 15-30 minutes of incubation. Digestion of sperm was found at 45-75 minutes and was complete at 90-105 minutes.Conclusions T.vaginalis tends to parasitize at the fornix o f the vagina, because this is the site where columnar cells are rich in mucinogen granules and thei r microvilli are helpful for adhesion and nibbling. T.vaginalis possesses some invad ing and attacking abilities. Shape change, canalization, encystation, phagocytosis, digestion, the cell coat, cytoskeleton, and lysosome all play important roles in the process of adhesion. They have two methods of phagocytosis: nibbling and ingestion. Genitourinary epithelium may be injured directly by the digestive action of hydrolases, phagocytosis, and the mechanical action of pseudopodia.

A systematic identification of Kolobok superfamily transposons in Trichomonas vaginalis and sequence analysis on related transposases

Transposons are sequence elements widely distributed among genomes of all three kingdoms of life, providing genomic changes and playing significant roles in genome evolution. Trichomonas vaginalis is an excellent model system for transposon study since its genome （- 160 Mb） has been sequenced and is composed of - 65% transposons and other repetitive elements. In this study, we primarily report the identification of Kolobok-type transposons （termed tvBac） in T. vaginalis and the results of transposase sequence analysis. We categorized 24 novel subfamilies of the Kolobok element, including one autonomous subfamily and 23 non-autonomous subfamilies. We also identified a novel H2CH motif in tvBac transposases based on multiple sequence alignment. In addition, we supposed that tvBac and Mutator transposons may have evolved independently from a common ancestor according to our phylogenetic analysis. Our results provide basic information for the understanding of the function and evolution of tvBac transposons in particular and other related transposon families in general.

Frequency and molecular diagnosis of trichomoniasis in symptomatic women referred to laboratories in urmia north west Iran

Objective:To obtain the frequency of trichomoniasis and molecular diagnosis among women referred to a laboratory in Urmia (north west Iran).Methods: In the cross sectional study during the year 2014-2015, women with complaints of abnormal discharge, itching, irritation and unpleasant odor were studied using convenience sampling. These people were referred to one of the laboratories in town by gynecologist. After preparing the checklist of underlying data, vaginal wet smear samples was prepared to assess andChi-square in terms ofTrichomonas vaginalis(T. vaginalis) infection was examine. And results were analyzed with statistical tests. Results: 11.1% of referred casese were 30-40 years old, and about 54.8% of referred were illiterate and primitive. The frequency of trichomoniasis was 11.1% and statistically there was no significant difference. There was no significant difference among the age, education level, method of contraception, marriage age, location, employment status and the number of delivery withT. vaginalis.Conclusion:T. vaginalis compared to other studies have a moderate prevalence among women of Urmia. Because of the concordance of this infection with other sexual transmitted diseases, it is recommended that further studies of the prevalence of these diseases in Urmia be done.

Impact of sexually transmitted infections on women health

Sexually transmitted infections (STIs) are the infections that can be transmitted from one sex partner, who already has such infection, to another. The causes of STIs in human are very well elucidated and their causative agents are identified as bacteria, parasites and viruses. The worldwide epidemiology of more than 20 types of STIs has been established, which includes diseases like Chlamydia, Gonorrhea, Genital herpes, HIV/ AIDS, HPV, Syphilis and Trichomoniasis. Though STIs affect both men and women indiscriminately, however, the pathophysiology of disease is more obvious among women. Other than abstinence, the most effective way to prevent the transmission or acquisition of STIs is to use a condom during sexual intercourse. Condoms are effective in decreasing the transmission of HIV. However, once contacted, STIs caused by bacteria or parasites can be treated with antibiotics. STIs caused by a virus may not virtually have any cure though the medicines may keep the disease under control. Correct usage of preventive measures greatly reduces but does not completely eliminate the risk of catching or spreading STIs.

Antiprotozoal Activity of a <i>Thymus vulgaris</i>Methanol Extract and Its Fractions

Introduction: Thymus vulgaris is used in traditional medicine to treat gastrointestinal diseases because of its antifungal, antibacterial, and antispasmodic activity. Objective: To verify whether Thymus vulgaris also has antiprotozoal activity against Trichomonas vaginalis, Giardia lamblia and Entamoeba histolytica trophozoites. Materials and methods: Conventional cultures of parasites were measured on the third day during the logarithmic growth phase. The antiprotozoal activity of the methanol extract and its fractions were evaluated comparing growth in cultures with and without extracts. Next, the extract was fractionated by polarity-based partitioning. Then, the purity of each fraction was determined by thin layer chromatography (TLC). The percentage of growth inhibition was calculated with respect to untreated controls. The 50% inhibitory concentration (IC50) of each extract was calculated by PROBIT analysis. Results: We found that a methanol extract of the aerial parts of Thymus vulgaris, at 300 μg/mL, inhibited the in vitro growth of G. lamblia and T. vaginalis, while E. histolytica growth was poorly inhibited. The methanol extract was further separated into mixtures of ursolic, oleanolic, and betulinic acids. The IC50 values of ursolic acid against G. lamblia and T. vaginalis were 8.12 μg/mL and 5.51 μg/mL, respectively. Conclusions: The methanol extract fraction containing ursolic acid obtained from Thymus vulgaris has antiprotozoal activity against G. lamblia and T. vaginalis trophozoites.

Sexually Risky Behavior in College-Aged Students

Objective: To examine college-aged students’ sexual risk taking behavior and their knowledge level. Design: descriptive design participants. Setting: A convenience sample of college-aged students between the ages of 17 - 25. Results: Seven hundred and seventy students responded to the survey. Findings revealed that 33% had sexual intercourse with two to five individuals, and 15.5% between eleven and twenty sexual partners. 50.9% had unprotected vaginal intercourse not using condoms and of those 45.8% either do not insist on condom use or only use them occasionally. 22.1% do not insist on using condoms for sexual intercourse and 24.7% responded that they sometimes insist on condom use. 47.2% are not worried about getting AIDS. 41.3% are not concerned with genital lesions. 42.4% would rate themselves as not being very knowledgeable about sexually transmitted infections. 12.4% of the females had unintended pregnancies and overall 74.9% would not feel comfortable discussing their sexual activity with their mothers. 58.1% use alcohol prior to or during sexual intercourse.

Vaginal Discharge in the Prostitutes of the Group Yèrêlon of Bobo-Dioulasso: Epidemiological, Clinical and Etiological Aspects

The authors report a cross-sectional descriptive study over 6 years, from December 8th, 2003 to October 27th, 2009, involving 911 women involved in the sex trade within the Yèrêlon group in Bobo-Dioulasso. Objectives: To describe the epidemiological, clinical and etiological aspects of vaginal discharge in women in the Yèrêlon group of the city Bobo-Dioulasso. Results: Frequency of vaginal discharge was 48.89%. The mean age was 28.4 years with extremes of 16 and 54 years. Single, divorced and widowed women accounted for 78.8% of the study population. Women who never attended school and those with primary education accounted for 74.3% of the study population. HIV serology was positive in 38.4% of cases. The main symptoms were genital itching, dyspareunia and urinary signs. The main germs identified in the laboratory were Candida albicans, Trichomonas vaginalis and Gardenerella vaginalis. Conclusion: vaginal discharge was found in 48.89% of women in the Yèrêlon group of Bobo-Dioulasso. The clinical study of the discharge and the laboratory results allowed a diagnosis and a better management of the leucorrhea in the group Yèrêlon.

Gynecologic infections seen in ThinPrep cytological test in Wuhan, China

This study aimed to analyze the prevalence of bacterial, Candida, Trichomonas, and human papillomavirus （HPV） infections in ThinPrep cytological test （TCT） performed on women of Wuhan, China. ThinPrep smears were screened by two independent experienced pathologists and reported from 2008 to 2010. A total of 46 866 ThinPrep smears were studied, and smears with inflammation were analyzed. Of the 44 162 enrolled patients, inflammation changes were observed in 21 935 （49.7%） and specific infections in 6884 （31.4%）. The infections detected were as follows： bacteria, 5663 （82.3%）; Candida, 825 （12.0%）; Trichomonas, 273 （4.0%）; and HPV, 148 （2.1%）. Significant changes were found in the prevalence of bacteria and Candida among women who underwent TCT before and after 2010. Z2 revealed an increasing proportion of specific infections found in smears after 2010 （P = 0.000）. In conclusion, bacterial infection was the most detectable in the ThinPrep smears, followed by Candida and Trichomonas. The prevalence of infection identified by TCT was found to be similar in previous literature in China.

Identifcation of the Phosphorylated Residues in TveIF5A by Mass Spectrometry

The initiation factor elF5A in Trichomonas vaginalis （TvelF5A） is previously shown to undergo hypusination, phosphorylation and glycosylation. Three different pI isoforms of TvelF5A have been reported. The most acidic isoform （pI 5.2） corresponds to the precursor TvelF5A, whereas the mature TvelF5A appears to be the most basic isoform （pI 5.5）. In addition, the intermediary isoform （pI 5.3） is found only under polyamine-depleted conditions and restored with exogenous putrescine. We propose that differences in PI are due to phosphorylation of the TvelF5A isoforms. Here, we have identified phosphorylation sites using mass spectrometry. The mature TvelF5A contains four phosphorylated residues （$3, T55, T78 and T82）. Phosphorylation at $3 and T82 is also identified in the intermediary TvelF5A, while no phosphorylated residues are found in the precursor TvelF5A. It has been demonstrated that elF5A proteins from plants and yeast are phosphorylated by a casein kinase 2 （CK2）. Interestingly, a gene encoding a protein highly similar to CK2 （TvCK2） is found in T. vaginalis, which might be involved in the phosphorylation of TvelF5A in T. vaginalis.